Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
24 Cards in this Set
- Front
- Back
|
Inner core is the
|
Medulla
|
|
|
outer shell is the
|
cortex
|
|
|
Medulla is essential for life?
|
No
|
|
|
Cortex essential for life?
|
Yes
|
|
|
Medulla produces which hormones?
|
epinephrine (Adrenalin) (90% and stronger) and norepinephrine (10%)
|
|
|
Action of medulla hormones
|
Fight or flight
|
|
|
Secretion of medulla hormones controlled by
|
hypothalmus
|
|
|
Epinephrine actions (5)
|
1.Glycogenolysis - raising metabolic rate and BS
2. sends bld to brain, muscles, hrt 3. increases BP, P, CO, R, dilates resp passages 4. Stimulates CNS alert, excited 5. Inhibits GI tract |
|
|
Norepinephrine actions (3)
|
1. increases BP - via extensive vasoconstriction
2. Increases body metabolism slightly 3. inhibits GI tract |
|
|
Disorder of adrenal medulla - only 1
|
Pheochromacytoma - a secreting tumor, usu benign, causes hyperactivity of medulla - produces state of anxiety all the time
|
|
|
s&s pheochromacytoma (5)
|
hypertension
hypermetabolism hyperglycemia acute unpredictable attacks spontaneous or due to cold, stress, etc |
|
|
S&S pheochromacytoma - visible (8)
|
sweating,
nervous, tremors, incr BP, P, pounding HA, palp, n/v, pallor |
|
|
Results during attacks- pheochromacytoma
|
CVA, blindness or death due to hi BP (can be 259/150) and intracranial hemorrhage
|
|
|
DX pheochromacytoma 1
|
VMA assay - done on 24 hr urine (3 days < no choc, van, fruit, coffee, tea, drugs)
|
|
|
DX pheochromacytoma 2
|
Assay of blood catecholamines - catheter in 15 min < blood drawn to lessen anxiety - raises values
|
|
|
DX pheochromacytoma 3 - if 1 &2 don't dx
|
clonidine suppression test: - antiadrenergic drug - suppresses catech. Ck levels < med given and 1-3 hrs >.
No change = pheochromacytoma (norm levels would dec) |
|
|
Other tests to dx
|
CT, u/s, MRI, etc.
MIBG procedure used to ID tumor and detect mets outside adrenals |
|
|
Rx
|
surgical removal of tumor
|
|
|
Pre-op
|
prevent hi BP - takes 1 wk to control w alpha blkers.
Dose grad inc until mild hypotens. (s/e tach, arrhythm, gi, flushing). Use Inderal for dysrhythm |
|
|
for pre-op hi BP (8)
|
bedrest HOB elevated (orthost drop)
seds, no caffeine, req bathing for sweating Diet hi cal, vits, mins Assist OOB - visual disturb avoid exerc, anxiety, no palpat ab - cause release catechol Assess vs, s&s to determine when pt ready for surg |
|
|
pre-op teaching
|
C & DB, T&P,
2 IV's running, * BP taken Q 2-5 min post op* |
|
|
post op care
|
monitor F & E, BS, EKG
Hi BP mya persist 2-4 days **most import - ck for hypotens** pain meds and s/e (hypotens) |
|
|
post-op care IVs
|
1 IV dopamine to keep BP in safe range - ck Q 2-5 min.
|
|
|
Post op ck for adrenocortical insuff - from cortex disruption while cutting into for medulla removal
|
n/v, hypotens, hypoglyc
often start IV steroids < surg thru post op, give cortisone for few wks, if both removed, cortisone for life Several days > surg, ck bld, urine catechol to see if surg successful |
